NEW DELHI: Priya Kapoor (name changed), a working professional from Delhi, was pregnant for the first time at 33. As if the stress of being pregnant was not enough, she was diagnosed with hypothyroidism – a condition where the thyroid gland doesn't produce enough hormones, and one feels tired or gains weight unexpectedly.
She was advised to follow a nutritious diet, engage in light exercises like walking, and practice stress-relieving techniques such as meditation and deep breathing. Along with these lifestyle modifications, she was prescribed thyroid hormone replacement therapy and was encouraged to consume iodised salt, as iodine deficiency is a common cause of thyroid imbalances. All these steps helped her immensely as, in November 2024, she delivered a healthy baby without any complications.
According to Dr Manju Gupta, senior consultant, obstetrician and gynaecologist, Motherhood Hospitals, Noida, who treated Priya, in many cases, hypothyroidism during pregnancy is temporary and resolves after childbirth. In Priya's case, it was the same.
More common in women
Experts say that pregnancy-induced thyroid disorders, gestational diabetes mellitus and gestational hypertension are common problems in women during gestational period – the time between conception and birth when a baby grows in the mother's womb. Studies across the country have given an 8-15% prevalence of thyroid disorders in pregnancy.
However, in the last five years, experts say they are seeing a sharp rise in thyroid cases, in general, in the country. "I am seeing 10-15 women, aged 33-45, monthly with thyroid problems, mainly hypothyroidism," Dr Gupta said. She adds that thyroid problems are rising in pregnant women and women in the reproductive age group of 25 to 45 years.
The word 'thyroid' is not a disease, it is the name of a small, butterfly-shaped gland in the neck. It is a part of one's endocrine system and controls many of the body's essential functions by producing and releasing thyroid hormones like thyroxine (T4) and triiodothyronine (T3). These two hormones regulate metabolism, energy levels, reproduction, and bodily functions. When the gland produces less hormone it is called hypothyroidism (underactive thyroid) and if it makes more it is called hyperthyroidism (overactive thyroid).
Apart from these common disorders, there are more uncommon problems like thyroid nodules and thyroid cancers as well.
Agreeing that thyroid issues during pregnancy have been on the rise recently, Dr Kavya Krishnakumar, consultant obstetrician and gynaecologist at Motherhood Hospital, Chennai, said that as women age and have children later in life, the risk of thyroid issues during pregnancy increases. "Pregnancy naturally affects thyroid hormone levels due to the body's changing needs to support the developing baby. In some cases, the thyroid gland is unable to adjust to these changes, which can lead to either hypothyroidism or hyperthyroidism." Both conditions can have serious consequences on the health of the mother and baby, including an increased risk of complications such as preterm birth, low birth weight, and developmental issues in the baby.
Also, it could lead to an increased chance of miscarriage and increased chances of ICU admissions. In the mother, it increases the risk of preeclampsia (a serious pregnancy condition that involves high blood pressure and other symptoms), post-partum haemorrhage, maternal heart rhythm abnormalities, and even heart failure in undiagnosed untreated cases.
"Nutritional deficiencies, such as a lack of iodine or iron, can also contribute to thyroid problems, making it crucial for pregnant women to monitor their thyroid health and seek timely treatment if needed," Dr Krishnakumar said. It has also been seen that consumption of processed food is causing hormonal fluctuations, so avoiding them is the best bet. Screening before planning pregnancy, especially if there is a family history, is a good idea, says Dr Sridevi Paladugu, consultant endocrinologist, Apollo Hospitals, Jubilee Hills, Hyderabad.
Rise in cases
Thyroid disorders are increasingly being diagnosed across India. This rise isn't necessarily about more people getting sick, but more about improved medical awareness and diagnostics, says Dr Usha Menon, Clinical Professor of endocrinology and Diabetes at Amrita Hospital in Kochi, Kerala.
Hypothyroidism is significantly more prevalent at about 3%, and hyperthyroidism is less than 2%. "The prevalence of thyroid disorders in India varies by age, gender, and state. Historically, iodine deficiency was a major cause. Thyroid gland swelling called 'goitre' is seen in about 4-7% of the Indian population," Dr Menon added. Studies indicate that thyroid disorders affect about 10-12% of the Indian population. "India has become iodine replete, which reduces the chances of iodine deficiency disorders to a large extent but has reportedly increased the chances of autoimmune thyroid disorders," said Dr Paladugu.
This rise has many reasons, mainly sedentary lifestyles, poor dietary habits, rising stress levels, and environmental factors like iodine deficiency and pollution.
Women more prone
Women are more prone to thyroid disorders than men who are largely protected from thyroid problems due to their Y chromosome. Studies have suggested women are nearly five to eight times more likely to develop thyroid imbalances.
"This is due to hormonal fluctuations during puberty, pregnancy, and menopause, which influence thyroid function. Autoimmune disorders, such as Hashimoto's thyroiditis, also predominantly affect women," added Dr Krishnakumar. So, how do you spot one suffering from thyroid? The symptoms of both hyperthyroidism and hypothyroidism are different. In hypothyroidism, a person may feel fatigued, gain unexplained weight, feel depressed, and suffer from slower than usual heart rate, while in hyperthyroidism, it is the exact opposite. A person might feel unexplained weight loss and have a faster-than-usual heart rate.
Treatment
Thyroid function disorders can be diagnosed with blood tests. Proper diagnosis is the key to effective treatment of thyroid disorders. Depending on the type of disorder and the patient's symptoms, treatment involves oral medications. While hypothyroidism is managed with hormone replacement therapy, hyperthyroidism may require medications, radioactive iodine, or surgery.
"Once a diagnosis is confirmed, healthcare professionals can prescribe appropriate medications, such as synthetic thyroid hormones for hypothyroidism, antithyroid medications, and beta-blockers for hyperthyroidism," said Dr Menon. These medications help restore the balance of thyroid hormones in the body, alleviating symptoms and improving overall well-being.
Monitoring thyroid hormone levels is another important aspect of managing thyroid disorders. "By monitoring hormone levels through periodic blood tests, doctors can ensure the treatment is effective and make any necessary adjustments. This ongoing evaluation helps maintain optimal hormone balance and minimises the risk of complications," said the doctor from Kochi.
Universal newborn screening programmes have been established to identify hypothyroidism at birth, allowing for the prompt introduction of thyroxine treatment if needed and preventing potential growth retardation. Untreated thyroid disorders can lead to serious health issues, including heart and nervous problems, digestive, infertility, goitre, musculoskeletal systems, developmental delays in children, and, in severe cases, life-threatening conditions like myxedema coma. In children, early detection of hypothyroidism is crucial to prevent severe impairments in mental and physical growth.
As prevention is better than cure, Dr Krishnakumar also suggested preventing thyroid by balancing lifestyle with mindful dietary choices. A thyroid-friendly Indian diet should include iodine-rich foods like fish and dairy (curd, paneer) and iron sources such as spinach, jaggery, and lentils.
Selenium from nuts and seeds, and zinc from pumpkin and cashews also support thyroid function. "Limiting processed foods, excessive soy, and raw cruciferous vegetables is best. It should be combined with stress management and regular check-ups. Consult your doctor before making any dietary changes, as the diet depends on the severity and type of thyroid condition," Dr Krishnakumar said.